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Women's Health: Can doctors mend a broken heart?

Most patients recover quickly, but the condition can be fatal and may even recur

Medical science has shown that people really can die of a broken heart.

Broken heart syndrome – known by the technical name apical ballooning syndrome (ABS) – was recognized in the medical literature only in the 1990s. It is characterized by a reversible malfunction of the left ventricle, the heart’s main pumping chamber, after emotional stress such as loss of a loved one or physical stress such as surgery or an automobile accident. ABS has been diagnosed mainly in postmenopausal women, but the reasons for this, and the underlying causes, remain unknown.

In what they are claiming is the largest review of this condition ever conducted, researchers at the Mayo Clinic in Rochester, Minn., studied 100 confirmed cases of ABS, finding that one in 10 patients suffered a recurrence of the syndrome within a four-year period. Furthermore, patients with ABS associated with physical stress were less likely to survive than patients who had suffered emotional stress.

Of the 100 patients, 17 had died within the followup period, and in most of these cases the event precipitating the ABS was physical, notes Dr. Charanjit Rihal, a cardiologist and study researcher. Since these patients were suffering other physical ailments, it is not surprising their mortality rate was so high, he says.

Rihal doesn’t have an explanation for the high rate of ABS recurrence, but he speculates that some people might have a genetic predisposition toward developing the condition.

In a second study, Rihal and his colleagues examined the heart’s blood supply in 51 female ABS patients and 14 patients without the syndrome. They found that 69 per cent of ABS patients had abnormal blood flow in the small vessels feeding the heart. “We think this finding is a clue to the cause of ABS.”

ABS mimics a heart attack, but most patients tend to recover quickly, Rihal says.